Academic Journal
Clinical Decision-Making and Guideline Alignment Among Brazilian Physical Therapists: Evidence From Standardized Carpal Tunnel Syndrome Vignettes.
| Τίτλος: | Clinical Decision-Making and Guideline Alignment Among Brazilian Physical Therapists: Evidence From Standardized Carpal Tunnel Syndrome Vignettes. |
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| Συγγραφείς: | Fernandes LFRM; Department of Applied Physiotherapy, Universidade Federal do Triângulo Mineiro, Uberaba, Minas Gerais, Brazil.; Graduate Program in Physical Education, Universidade Federal do Triângulo Mineiro, Uberaba, Minas Gerais, Brazil.; Graduate Program in Physiotherapy, Universidade Federal do Triângulo Mineiro and Universidade Federal de Uberlândia, Uberaba and Uberlândia, Minas Gerais, Brazil., Cardoso BTA; Graduate Program in Physical Education, Universidade Federal do Triângulo Mineiro, Uberaba, Minas Gerais, Brazil., Paranhos DB; Graduate Program in Physical Education, Universidade Federal do Triângulo Mineiro, Uberaba, Minas Gerais, Brazil., Castro VHM; Graduate Program in Physiotherapy, Universidade Federal do Triângulo Mineiro and Universidade Federal de Uberlândia, Uberaba and Uberlândia, Minas Gerais, Brazil., Resende AA; Graduate Program in Physiotherapy, Universidade Federal do Triângulo Mineiro and Universidade Federal de Uberlândia, Uberaba and Uberlândia, Minas Gerais, Brazil., Serrão PRMDS; Department of Physiotherapy, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil. |
| Πηγή: | Journal of evaluation in clinical practice [J Eval Clin Pract] 2026 Sep; Vol. 32 (6), pp. e70575. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 9609066 Publication Model: Print Cited Medium: Internet ISSN: 1365-2753 (Electronic) Linking ISSN: 13561294 NLM ISO Abbreviation: J Eval Clin Pract Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Oxford, England : Wiley-Blackwell, c1995- |
| Ιατρικοί όροι (MeSH): | Clinical Decision-Making*/methods , Physical Therapists*/standards , Guideline Adherence*/statistics & numerical data , Carpal Tunnel Syndrome*/therapy , Practice Guidelines as Topic*, Humans ; Brazil ; Cross-Sectional Studies ; Female ; Male ; Adult ; Middle Aged ; Surveys and Questionnaires ; Evidence-Based Practice |
| Περίληψη: | Background: Clinical practice guidelines (CPGs) are intended to support evidence-based clinical decision-making. However, the extent to which physical therapists' clinical decisions align with guideline recommendations remains uncertain, particularly in Brazil. Objective: To evaluate the alignment of Brazilian physical therapists' clinical decisions with recommendations from CTS clinical practice guidelines and to examine whether general evidence-based practice (EBP) knowledge, self-reported guideline use, and condition-specific guideline knowledge are associated with this alignment. Methods: A cross-sectional study was conducted using an online questionnaire comprising two clinical vignettes representing mild and moderate CTS. Participants selected assessment and treatment strategies, which were scored using a weighted guideline-alignment system based on the strength of the supporting evidence. Scores were expressed as percentages. Between-group comparisons were performed using Welch's independent t-tests, and effect sizes were estimated using Cohen's d. Results: A total of 282 physical therapists were included. Overall alignment with guideline recommendations was low (mean 46.2%, SD 10.7), with similarly low scores for assessment (45.9% ± 14.5) and intervention (46.5% ± 11.7). No significant associations were observed between guideline alignment and any of the investigated variables (all p > 0.05). Effect sizes were uniformly small. All participants selected at least one non-recommended intervention, and 66.7% selected at least one non-recommended assessment procedure. Conclusion: Clinical decisions made by Brazilian physical therapists showed limited alignment with CTS clinical practice guideline recommendations. General EBP knowledge, self-reported guideline use, and condition-specific guideline knowledge were not significantly associated with guideline alignment, and all observed effect sizes were small. These findings suggest that improving guideline implementation requires addressing factors beyond individual knowledge and highlight the importance of behavioural, organizational, and contextual determinants of clinical decision-making. (© 2026 The Author(s). Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.) |
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| Grant Information: | 001 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) |
| Contributed Indexing: | Keywords: Carpal Tunnel Syndrome; clinical decision‐making; clinical practice guidelines; evidence‐based practice; guideline implementation; physical therapy |
| Entry Date(s): | Date Created: 20260831 Date Completed: 20260831 Latest Revision: 20260926 |
| Update Code: | 20260926 |
| PubMed Central ID: | PMC13527589 |
| DOI: | 10.1111/jep.70575 |
| PMID: | 42670593 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1365-2753 |
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| DOI: | 10.1111/jep.70575 |